Organization
PEDIATRIC RADIOANESTHESIA SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. O R DAVIS MD,PA (ANESTHESIOLOGIST)
(972) 840-2804
Entity
Organization
Contact information
Practice address
3200 BROADWAY BLVD, SUITE 350, GARLAND, TX 75403
(972) 840-2804
(972) 840-2884
Mailing address
3200 BROADWAY BLVD, SUITE 350, GARLAND, TX 75043-1573
(972) 840-2804
(972) 840-2884
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
J5299
TX
Other
Enumeration date
05/20/2009
Last updated
05/20/2009
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